So far, metformin is still one of the basic drugs for patients with type 2 diabetes, its tolerance is good, the hypoglycemic effect is clear, in addition to hypoglycemia, it has also been found to improve metabolism, life extension and other multiple effects, is a hypoglycemic drug that many friends are taking.
If you want to control blood sugar levels, in addition to rational medication, you also need to strengthen exercise, reasonable exercise is a very important aspect for diabetic patients to enhance body metabolism, strengthen blood sugar utilization, and strengthen blood sugar control.
There are many studies that have evaluated the optimal time to exercise in diabetic patients, and some studies in recent years have shown that exercise in the afternoon or evening is associated with better improvement of insulin resistance and better blood sugar control in diabetic patients, however, for patients taking metformin, current studies have proven that metformin can change the adaptation of skeletal muscle mitochondria to exercise, and may also interfere with the hypoglycemic effect of exercise, therefore, for diabetic patients taking metformin, the optimal exercise time may vary due to the effect of the drug。
IN A RECENT STUDY PUBLISHED IN THE JOURNAL OF PHYSIOLOGY, RESEARCHERS EVALUATED THE OPTIMAL TIMING OF METFORMIN AND EXERCISE IN PATIENTS WITH TYPE 2 DIABETES. The results of the study showed that:
- Moderate exercise in the morning can dramatically lower blood sugar levels in people with type 2 diabetes who take metformin.
- This benefit occurred mainly in participants who took metformin before breakfast.
- During the last week of the experimental intervention (week 6), morning exercise combined with pre-breakfast metformin was still able to consistently lower blood glucose compared to metformin after breakfast.
In this study, the researchers selected diabetic patients treated with metformin as participants to evaluate the effect of exercise from 7 a.m. to 10 a.m. and exercise from 16 p.m. to 19 p.m. on blood sugar on blood sugar under the premise of similar daily caloric intake, and finally included a total of 18 participants, randomized these patients, and conducted a 16-week crossover trial, in which participants were randomly assigned to morning and evening exercise groups, and were asked to perform moderate-intensity exercise on alternate days.
The study evaluated the 24-hour area under the glucose curve (AUC) of the participants, which is a more comprehensive assessment of blood glucose control in diabetic patients than fasting blood glucose levels, which can represent the body's blood glucose changes in 24 hours, and is an important indicator of insulin sensitivity and pancreatic β cell function.
The results showed that the 24-hour glucose AUC of participants who exercised in the morning was significantly lower than the baseline level before participating in the study, while the 24-hour glucose AUC level of participants who exercised in the evening showed no significant change. After further analyzing the time of metformin medication in the morning exercise group, the researchers found that the participants who achieved significant improvement in blood sugar in the morning exercise group were basically those who took metformin before breakfast, and their 24-hour glucose AUC levels were significantly reduced compared with those who took the medication after breakfast.
The investigators also stated that morning exercise combined with pre-breakfast metformin sustainably reduced glucose AUC compared to metformin after breakfast until the last week of the intervention (week 6). In this crossover trial, there were no significant differences in exercise intensity, caloric intake, or overall force activity (morning versus evening exercise) between test groups. This also shows that the combination of morning exercise and metformin before meals is indeed more effective in strengthening blood sugar regulation.
In this study, the investigators recruited two cohorts in the summer and winter to account for possible observed seasonal differences. The results showed that although the winter group did have consistently higher glucose AUC levels for all periods of the trial, there was no statistically significant difference between the winter and summer groups, so there were no seasonal differences in the timing of metformin administration and the timing of exercise.
All in all, the results of the study suggest that for people with type 2 diabetes taking metformin, if they can follow the "medication rule" of exercising at 7 to 10 a.m. and taking metformin 30 minutes before breakfast, they may get better results in terms of enhancing the hypoglycemic effect of the drug.
Metformin, as a classic hypoglycemic drug, is generally recommended to be taken after meals to reduce the risk of adverse reactions in addition to enteric-coated tablets due to its potential gastrointestinal irritation, but the research published this time shows that in order to better exert the efficacy of the drug, taking metformin before meals and exercising at a reasonable time may become an optimized way to further enhance the hypoglycemic effect of the drug.
Of course, this medication method is not suitable for everyone, if you take metformin on an empty stomach for people who are intolerant, it may not be suitable for this medication method, and if you are a diabetic patient with a certain risk of hypoglycemia in the morning, you should also pay attention to the risk of hypoglycemia that exercise may bring, but in any case, this study gives a new idea of medication, that is, a reasonable medication time, coupled with a reasonable exercise time, may make the blood sugar of diabetic patients be better and more stable.
Bibliography:
Morning exercise and pre-breakfast metformin interact to reduce glycaemia in people with type 2 diabetes: a randomized crossover trial. J Physiol. 2024 Mar 24.